In this InSight Studio interview from SECO2019, we speak with Dr. Richard Madonna from SUNY Optometry, where he explains why hypertension is a risk factor for glaucoma. (surprisingly, the answer has part to do with hypotension!
Thanks again for Dr. Madonna for sitting down with us. I appreciated his "tips" on modifying when the patients take their HTN meds to reduce the risk. The big question is can you get a cardiologist (or GP for that matter) to agree to adjust the patient's dosing schedule?
BTW, Dr. Madonna also has a course at CEwire2019 about systemic disease & optometry, if you haven't seen it yet, here's an excerpt: You can watch the full show from now until July 1st at CEwire2019! -- ad
New patient comes to your office. 55wm. He’s being treated for hypertension and reports it’s controlled well. BP in office is 120/80. Cd is 0.3 OU. Is this patient a glaucoma suspect? If so....what tests do you order?
You have not told us enough to decide. What are the rim ratios? VDD? IOPs? However, I tell my students there are two types of patients: glaucoma suspects, and glaucoma patients.
Let's assume it's all "normal." The question is.....is a patient with controlled hypertension a glaucoma suspect? If so, what tests, if any should be ordered?
Yes they are a suspect, all patients are. But there level of suspicion is low. I don't think you can medically justify any glaucoma testing unless you notice a change or have something suspicious. If I did any testing it would be an OCT of the GCC and RNFL.
